Fish protein wafers to ease acute malnutrition in children

By Fatima Arkin

[MANILA] A snack based on fish proteins, launched last month (17 December), is expected to help the Cambodian government reach its goal of treating at least 25,000 children for severe acute malnutrition every year.

Eventually, production of this snack could be expanded to help over five million children under the age of five in East Asia and the Pacific who are affected by severe acute malnutrition annually, according to Arnaud Laillou, a nutrition specialist at UNICEF Cambodia. Laillou points to the Lao PDR and Myanmar as countries in the region that could readily adopt the product.

“The final tests of the product were essential as Cambodia is one of the first countries to use fish protein in therapeutic food.”

Arnaud Laillou, UNICEF Cambodia

Acutely malnourished children are nine times more likely to die than well-nourished children, according to UNICEF. Typically, they have severe muscle wasting and swollen feet, face and limbs and need emergency care, including therapeutic food, to survive.

The new snack, called Nutrix, offers a locally produced alternative to imported therapeutic foods that are usually made with peanut and milk powder.

Approximately 2.6 per cent of children in Cambodia suffer from severe acute malnutrition while another eight per cent have moderate to acute malnutrition.

Home-based, ready-to-use therapeutic foods are often prescribed for an estimated 60,000 to 90,000 Cambodian children who need specialised medical treatment annually, according to UNICEF. The organisation also notes that local research has shown low uptake of existing products in Cambodia’s healthcare facilities.

Nutrix presents a viable alternative. It is 20 per cent cheaper than imported counterparts. Cambodian children also find it more palatable, according to efficacy studies conducted by UNICEF. Additionally, fish is a staple in Asia-Pacific diets; the region provides almost 90 per cent of the world’s fish supply, according to the UN’s Food and Agriculture Organization (FAO).

“Nutrix came about after five years of research and hard work,” Laillou tells SciDev.Net. “The final tests of the product were essential as Cambodia is one of the first countries to use fish protein in therapeutic food.”

DCF’s partner company, Vissot Co., has a Bill and Melinda Gates grant to train workers in five local communities where the fish are caught to sort, clean and pack the fish for transport to their factory in Phnom Penh, says Shakuntala Thilsted, a research programme leader at WorldFish, an international non-profit.

Thilsted says by using native Cambodian fish instead of dairy like in other ready-to-use therapeutic foods, there is a higher likelihood of creating a system that fits the local supply. The optimised supply chain is predicted to reduce production costs by 60 per cent.

“Child stunting really accelerates very quickly at six months, exactly the time when kids should be introduced to nutrient-dense complementary foods. But it can be tough for nutrition programs to reach parents at six months (unlike prenatal or neonatal care),” Headey tells SciDev.Net.

“Even if these foods are designed to fit local tastes and cultural feeding practices, there’s still a novelty factor to them,” Headey says, adding that there’s an issue of consumers trusting the product and the “inevitable debate about whether the product would be delivered free through the health system”.